NCCN Guidelines for B-Cell Lymphomas V.1.

2022 – Annual – 01/21/22

Follicular Lymphoma (FOLL)

Guideline Page Institution Vote
Panel Discussion/References
and Request YES NO ABSTAIN ABSENT
FOLL-B 3 of 5 The panel consensus supported the removal of idelalisib as a 6 15 2 9
Internal request third-line and subsequent therapy option based on the
Comment to reassess the withdrawal of FDA indication.
continued inclusion of idelalisib
as a third-line and subsequent
therapy option for FL based on
the withdrawal of FDA
indication for relapsed FL.

Marginal Zone Lymphoma

Guideline Page Institution Vote
Panel Discussion/References
and Request YES NO ABSTAIN ABSENT
MZL-A 2 of 4 The panel consensus was to include axicabtagene ciloleucel 17 3 3 9
Internal request as an option for third-line and subsequent therapy for relapsed,
Comment to consider the refractory, or progressive disease in patients with indications
inclusion of axicabtagene for treatment (after ≥2 prior chemoimmunotherapy regimens).
ciloleucel as an option for This is a category 2A recommendation.
third-line and subsequent
therapy for relapsed,
refractory, or progressive
disease in patients with
indications for treatment (after
≥2 prior chemoimmunotherapy
regimens).

External request
Submission request from Kite
(12/12/21): Please consider
data on axicabtagene
ciloleucel under second-line or
subsequent therapy for
marginal zone lymphomas.
NCCN Guidelines for B-Cell Lymphomas V.1.2022 – Annual – 01/21/22

MZL-A 2 of 4 The panel consensus supported the removal of idelalisib as a 7 14 2 9

Internal Request second-line and subsequent therapy option for MZL based on
Comment to reassess the the withdrawal of the FDA indication.
continued inclusion of idelalisib
as a second-line and
subsequent therapy option for
MZL based on the withdrawal
of the FDA indication.

Diffuse Large B-Cell Lymphoma

Guideline Page
and Request
BCEL-9
Internal Request
Comment to consider the
inclusion of axicabtagene
ciloleucel (with bridging
therapy as clinically indicated)
as an option for relapsed
disease <12 mo or primary
refractory disease.
Institution Vote
Panel Discussion/References
YES NO ABSTAIN ABSENT
Based on the review of the data in the noted references, the 18 3 2 9
panel consensus was to include axicabtagene ciloleucel (with
bridging therapy as clinically indicated) as an option for
relapsed disease <12 mo or primary refractory disease. This is
a category 1 recommendation.
Locke FL, et al. Superiority of Axicabtagene Ciloleucel in Second-
Line Large B-Cell Lymphoma. [published online December 11, 2021]
N Engl J Med. 2021

External request
Submission request from Kite
(12/12/21): Please consider
data on axicabtagene
ciloleucel under the second-
line and subsequent therapy
section for diffuse large B-cell
lymphoma as a category 1
evidence
BCEL-C 2 of 6 The panel consensus was to include the following CAR T-Cell
Internal Request therapy bridging options. These are category 2A
Comment to consider the recommendations.
inclusion of the following CAR • DHA (dexamethasone, cytarabine) + platinum (carboplatin, 21 0 2 9
T-Cell therapy bridging cisplatin, or oxaliplatin) ± rituximab
options: 20 1 2 9
NCCN Guidelines for B-Cell Lymphomas V.1.2022 – Annual – 01/21/22

• DHA (rituximab, • GDP (gemcitabine, dexamethasone, cisplatin) ± rituximab 19 2 2 9

dexamethasone, or (gemcitabine, dexamethasone, carboplatin) ± rituximab
cytarabine) + platinum • GemOx (gemcitabine, oxaliplatin) ± rituximab 19 2 2 9
(carboplatin, cisplatin, or • ICE (ifosfamide, carboplatin, etoposide) ± rituximab 19 1 3 9
oxaliplatin) ± rituximab • Polatuzumab vedotin-piiq ± rituximab ± bendamustine (only
• GDP (gemcitabine, after leukapheresis)
dexamethasone, cisplatin)
± rituximab or
(gemcitabine,
dexamethasone,
carboplatin) ± rituximab
• GemOx (gemcitabine,
oxaliplatin) ± rituximab
• ICE (ifosfamide,
carboplatin, etoposide) ±
rituximab
• Polatuzumab vedotin-piiq ±
rituximab ± bendamustine
(only after leukapheresis)